Form 1 Block 4 - Created July 21 Flashcards
presentation of hypoplastic left heart syndrome
when PDA closes around day of life 1: will see severe cyanosis, respiratory distress, and cardiogenic shock; need immediate tx of PGE1 to keep PDA open
presentation of Staph aureus pneumonia
acute pulmonary sxs, rapidly progressive with acute decompensation, lower lobe infiltrate/cavitation; TB usually has upper lobe cavitation
what to do if mother is Rh(D)(-) and has (+)anti-RhD Ab’s
check for anemia and hydrops; giving Rhogam is useless as the mom has already undergone alloimmunization
presentation of pulmonary HTN
SOB, fatigue/weak, exertional angina, syncope, abd. distension/pain
PE and imaging with pulmonary HTN
signs of right HF (JVD, LE edema), ascites, hepatomegaly, loud P2, TR; CXR shows enlarged pulm aa and nothing else
standard prenatal lab panel
type and screen, CBC, U/A, UCx, tests for infections (rubella, varicella, syphilis, HIV, hep.B, chlamydia), pap test (?)
confounding variable
correlates with both dependent and independent variables; can alter results if not controlled for
effect modification
occurs when risk of a certain condition is present only within a certain subgroup of the population studied
when to repair umbilical hernia in child
age 5
underlying pathology in Gaucher disease
glucocerebrosidase deficiency
clinical features of Gaucher’s disease
hepatosplenomegaly, anemia, low plt’s, bony pain, FTT, delayed puberty
once PCOS dx made, what screening to do next?
oral GTT to check for DM; more accurate than HgbA1c
joint aspiration cell counts to help narrow DDX
<2000: OA
2000-75k: RA and gout
>100k: infectious
why early tx is important with shingles
reduces risk and severity of post-herpetic neuralgia and promotes healing of lesions
presentation of disseminated gonococcus
fever/chills malaise with purulent monoarthritis OR with triad of tenosynovitis, dermatitis (isolated pustules), migratory polyarthralgia
important fact about PEG tube placement
it does NOT improve outcomes in severely demented hospitalized patients
what will prevent long-term disability in an RA pt?
cytotoxic meds (hydroxychloroquine, MTX, TNF-a inhibitors, rituximab)
supportive features of potential Parkinson’s dx
bradykinesia, resting tremor, rigidity; asymmetric in presentation; improves with DA therapy
2 causes of acute renal failure in pt after cardiac cath
- aortic atheroembolism
2. contrast-induced nephropathy
when to suspect aortic atheroembolism
atherosclerosis, skin changes in legs (livedo reticularis or blue toe), elevated serum and urine eosinophils; (note cholesterol is part of the embolus -> cholesterol crystal embolization)
what to do in pt with hypovolemic hypoNa
give normal saline
when hypertonic saline is appropriate
Na < 120 AND having seizures, obtunded, coma, or respiratory arrest
mgt of acute pancreatitis
- IVF, pain meds
2. start soft, low fat diet when pt’s appetite returns OR begin NG feeds at 72h
mgt of gout pt starting meds for 1st time
allopurinol (to decr. uric acid production) + colchicine (as prophylaxis and a temp bridge); NSAIDs can be used in place of colchicine
what med can dissolve large uric acid stones
potassium citrate
what med can help increase urinary urate excretion
probenicid
CHADS-VASc scoring
2 pts: age >74, prior stroke or TIA
1 pt: CHF, HTN, DM, vasc. dz, 65-74, Female
effect on the heart with tension pneumothorax
air accumulates -> compressed vena cava -> decreased venous return -> hypotension
need tx for human bite but PCN allergic
usually give amoxi/clav; instead, give clinda/cipro
presentation of polycythemia vera
abnormal thrombotic event, splenomegaly, elevated Hgb, WBCs and plt’s
how to verify dx of polycythemia vera
genetics (mutated JAK2)
3 phases of postpartum thyroiditis
- hyperthyroid for 1-3 mo.
- hypothyroid for 4-6 mo.
- euthyroid
potential long-term complication of postpartum thyroiditis
usually transient, BUT, increased risk of persistent or recurrent hypothyroidism with a palpable goiter
